Transportation issues, staffing shortages and other barriers have made access to health care in New Hampshire’s rural areas challenging — the state’s plan for the next two years aims to address these problems through several key initiatives.
In its 2025–2027 Roadmap, the New Hampshire Department of Health and Human Services is looking to launch a new Rural Health Transformation Plan designed to improve access to high-quality, sustainable services at every point of care — from primary and maternal care to behavioral health services.
One of the department’s proposed initiatives is to develop a strategy to reduce hospital readmission rates in rural communities for chronic conditions such as heart disease and diabetes.
A readmission rate measures how often patients return to the hospital soon after discharge, typically within 30 days, and is an indicator that helps identify potential issues with the hospital stay or post-hospital care.
DHHS Commissioner Lori Weaver said in a statement that the roadmap expands and streamlines the department’s focus on the key issues most critical to clients, community partners and employees, especially during challenging financial times.
“Despite the challenges that lie ahead, this Roadmap represents the Department’s continued commitment to improving the health of those we serve and working with our provider and community partners to advance our common goals and priorities,” she said.
The need for these investments is clear. Between 2000 and 2021, nine of New Hampshire’s sixteen rural hospitals closed their labor and delivery units, according to a report from the New Hampshire Fiscal Policy Institute. This decline has left many expectant mothers in rural communities with limited access to maternal care.
In addition to rural health investments, the roadmap continues the state’s focus on behavioral health.
By August, DHHS plans to increase maternal mental health screening rates at Community Health Centers through new quality improvement initiatives. The department will also implement an outreach plan for healthcare providers and pregnant or postpartum women to ensure timely referrals and access to needed mental health support.
Mental health conditions were identified as the primary underlying cause in 58.3% of pregnancy-related deaths in New Hampshire between 2019 and 2023, according to a recent state report.
The roadmap also continues to make investments to achieve Mission Zero, an initiative to eliminate the practice of boarding patients who need inpatient psychiatric care in emergency rooms until a treatment bed becomes available.
Other efforts to strengthen health services in New Hampshire include expanding access to child care, improving community-based long-term care for older adults, launching re-entry programs in county correctional facilities to connect inmates with Medicaid as they return to their communities and improving the developmental disability service system.
The goals of the plan involve coordination and collaboration from nonprofits and other stakeholders.
“The real beauty of this plan is that it recognizes how connected we all are and that our individual contributions lead to collective success,” said Luke Reynard, executive director of NFI North, a nonprofit that offers mental and behavioral health supports.